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Mehmet Yilmaz, Julia Esser, Rodrigo Suarez-Ibarrola, Christian Gratzke, Arkadiusz Miernik University of Freiburg - Medical Centre, Faculty of Medicine, Department of Urology, Freiburg, GermanyCorrespondence: Arkadiusz MiernikUniversity of Freiburg – Medical Centre, Faculty of Medicine, Department of Urology, Hugstetter Str. 55, Freiburg, D-79106, GermanyTel +49 761 270-25821Fax +49 761 270-25829Email arkadiusz.miernik@uniklinik-Freiburg.deAbstract: Benign prostatic hyperplasia (BPH) is a common health condition in aging men resulting in lower urinary tract symptoms (LUTS) and low quality of life (QoL). We aimed to review studies on laser enucleation of the prostate (LEP) due to LUTS in elderly patients (> 65 years) comparing different age groups, particularly considering functional outcomes, safety, and perioperative complications. A comprehensive search was conducted using the PubMed-MEDLINE, Web of Science, Wiley Online Library and Cochrane Library databases over the last 10 years until 7 October 2021 with the following search terms solely or in combination: “laser enucleation”, “prostate”, “laser prostatectomy”, “aging”, “elderly patients”, “older patients” and “age”. We identified 12 articles for inclusion in our analysis. Five studies focussed mainly on holmium laser enucleation of the prostate (HoLEP), one compared HoLEP to other laser prostatectomy procedures, two studies examined thulium laser enucleation of the prostate (ThuLEP), and two studies focused on GreenLight laser, one study focussed on potassium-titanyl-phosphate (KTP) laser, and another study compared laser prostatectomy to transurethral resection of the prostate (TURP). These studies showed that LEP improved IPSS, Qmax and QoL compared to baseline regardless of age; no significant difference was reported among age groups. Although ASA scores and anticoagulation/antiplatelet therapy rates are higher in elderly patients, studies revealed no significant difference in perioperative complication rates between age groups. Laser enucleation of the prostate is an effective and safe procedure in elderly patients, resulting in good functional outcomes, low morbidity, and few perioperative complications.Keywords: aged, benign prostatic hyperplasia, elderly patients, HoLEP, laser enucleation of the prostate

Einleitung: Der transperineale Zugang für die Prostatabiopsie (TPB) bietet einen Ausweg aus dem aktuellen Dilemma der steigenden Zahl infektiöser Komplikationen nach transrektaler Biopsie. Unter der Annahme von sterilen Verhältnissen bei der TPB wurde auf eine routinemäßige [zum vollständigen Text gelangen Sie über die oben angegebene URL], 61. Jahrestagung der Südwestdeutschen Gesellschaft für Urologie e.V.

Einleitung: In der Diagnostik des Prostatakarzinoms (PC) soll nach geltender Leitlinienempfehlung zusätzlich zur MRT-gesteuerten Biopsie (TB) eine synchrone systematische Biopsie (SB) durchgeführt werden. Seit einem Konsensus-Meeting im Jahr 2013 wird empfohlen, die SB entsprechend des Ginsburg-Schemas[zum vollständigen Text gelangen Sie über die oben angegebene URL], 61. Jahrestagung der Südwestdeutschen Gesellschaft für Urologie e.V.

Einleitung: Die Zystoskopie und TUR-Blase sind der Goldstandard zur Diagnose und pathologischen Sicherung von Harnblasentumoren. Bildgebende Detektionstechniken (BDT) wie die photodynamische Diagnostik (PDD) oder das narrow band imaging (NBI) können die Tumordetektionsraten steigern sowie die Rezidivraten[zum vollständigen Text gelangen Sie über die oben angegebene URL], 60. Jahrestagung der Südwestdeutschen Gesellschaft für Urologie e.V.

Einleitung: In chirurgischen Disziplinen sollen praktische Fertigkeiten vor einem Patienteneinsatz idealerweise ex-vivo trainiert und gefestigt werden. Zur Steigerung der Trainingseffizienz sind wirklichkeitsgetreue Organmodelle notwendig. Bislang gibt es kein Modell, welches der Form, dem Aussehen [zum vollständigen Text gelangen Sie über die oben angegebene URL], 60. Jahrestagung der Südwestdeutschen Gesellschaft für Urologie e.V.

Forschungsfrage: Beurteilung der Beziehung zwischen Parametern der Körperzusammensetzung und Tumorprogression und Überlebenzeit bei Patienten mit kastrationsresistentem Prostatakrebs (CRPC), die eine Chemotherapie mit Docetaxel erhalten. Methodik: In dieser retrospektiven, unizentrischen[zum vollständigen Text gelangen Sie über die oben angegebene URL], 45. Gemeinsame Tagung der Österreichischen Gesellschaft für Urologie und Andrologie und der Bayerischen Urologenvereinigung

Background: To identify predictors of survival in patients treated with docetaxel chemotherapy for castration-resistant prostate cancer (CRPC). Methods: We retrospectively analyzed clinical data from 186 patients who underwent docetaxel chemotherapy for CRPC from 2005 to 2016 at a single center. Pretreatment baseline variables including demographic and clinicopathological data were reviewed. Disease progression was defined by imaging and/or consecutive prostate-specific antigen (PSA) elevation. The systemic immune-inflammation index (SII), the modified Glasgow Prognostic Score (mGPS), and the neutrophil-lymphocyte ratio (NLR) were calculated. Univariable and multivariable Cox proportional hazards regression analyses reporting hazard ratios assessed the risk for disease progression and overall survival (OS). A survival nomogram was constructed. Results: Most patients (n = 139, 74.7%) completed at least 6 cycles of docetaxel chemotherapy. 156 patients (82.9%) experienced disease progression during the studied period. Only mGPS was independently associated with disease progression in a multivariable model (P < 0.01). During the studied period, 98 patients (52.1%) died. The built survival nomogram included statistically significant variables for OS in univariable analysis: hemoglobin, PSA, alkaline phosphatase (AP), lactate dehydrogenase, SII, neutrophil-lymphocyte ratio, mGPS, and site of metastases; and had a concordance index of 0.703. At decision curve analysis, the nomogram led to superior outcomes for any decision associated with a threshold probability of above 40%. In multivariable analysis, only AP (P = 0.02), hemoglobin and PSA (P < 0.01, respectively) remained associated with OS. Conclusions: PSA, AP, and hemoglobin are independent prognosticators for OS. Although mGPS is a promising marker for tumor progression and SII is a plausible prognostic marker for OS, valid integration of inflammatory indices into a prognostic model requires validation studies. Predictive and prognostic biomarkers are desperately needed to guide physicians in treatment counseling given the heterogeneous nature of CRPC and the plethora of effective therapies.

Objectives To evaluate the impact of an eight-item surgical checklist (SC) on the recurrence-free survival (RFS) of patients with non-muscle-invasive bladder cancer (NMIBC) undergoing transurethral resection of bladder tumour (TURBT). Patients and methods A group of urologists at two tertiary referral centres, with expertise in bladder cancer, identified eight critical items that should be performed in every high-quality TURBT. An eight-item SC was prospectively implemented into clinical practice and the operative reports of TURBTs performed before and after implementation were reviewed. Results from both institutions were combined to estimate the impact of introducing the SC on oncological outcomes. Multivariable logistic and Cox hazards regression analyses were performed to evaluate the impact of the SC on the presence of detrusor muscle in the TURBT specimen and on RFS, respectively. Results The operative reports of 266 TURBTs performed after the SC implementation were reviewed and compared to those of 281 TURBTs performed prior to the SC introduction. The SC was independently associated with a significant improvement in RFS (P = 0.02). However, the introduction of the SC was not significantly associated with the presence of detrusor muscle in the surgical specimen (P = 0.4). Conclusion The use of an eight-item SC during TURBT in clinical practice increases the quality of operative reports thereby potentially improving individualised risk-stratification and care resulting in lower disease recurrence rates. Therefore, the introduction of a SC can be recommended to enhance oncological outcomes by improving surgical standardisation and operative reporting.